Examining the weekend effect across ICU performance metrics

• Published in: Critical care (London, England) England), 2019-06, Vol.23 (1), p.207-207, Article 207
• Main Authors: Faust, Louis, Feldman, Keith, Chawla, Nitesh V
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Critical care; Electronic records; Female; Healthcare; Healthcare informatics; Hospital Mortality - trends; Hospital patients; Hospitalization - trends; Hospitals; Humans; Intensive care; Intensive care units; Intensive Care Units - organization & administration; Intensive Care Units - standards; Intensive Care Units - statistics & numerical data; Logistic Models; Male; Medical informatics; Medical records; Medical research; Middle Aged; Mortality; Nosocomial infections; Patients; Pneumonia; Quality Indicators, Health Care - statistics & numerical data; Quality of care; Quality of Health Care - standards; Quality of Health Care - statistics & numerical data; Risk Factors; Statistics; Surgery; Time Factors; Weekend effect; Workforce planning
• ISSN: 1364-8535; 1466-609X; 1364-8535; 1366-609X
• DOI: 10.1186/s13054-019-2479-5

Known colloquially as the "weekend effect," the association between weekend admissions and increased mortality within hospital settings has become a highly contested topic over the last two decades. Drawing interest from practitioners and researchers alike, a sundry of works have emerged arguing for and against the presence of the effect across various patient cohorts. However, it has become evident that simply studying population characteristics is insufficient for understanding how the effect manifests. Rather, to truly understand the effect, investigations into its underlying factors must be considered. As such, the work presented in this manuscript serves to address this consideration by moving beyond identification of patient cohorts to examining the role of ICU performance. Employing a comprehensive, publicly available database of electronic medical records (EMR), we began by utilizing multiple logistic regression to identify and isolate a specific cohort in which the weekend effect was present. Next, we leveraged the highly detailed nature of the EMR to evaluate ICU performance using well-established ICU quality scorecards to assess differences in clinical factors among patients admitted to an ICU on the weekend versus weekday. Our results demonstrate the weekend effect to be most prevalent among emergency surgery patients (OR 1.53; 95% CI 1.19, 1.96), specifically those diagnosed with circulatory diseases (P